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	<p style="text-align: center; font-family: 宋体; font-size: 10.5pt;"><label style="font-size: 10.5pt; font-weight: bold;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">醫療機構</font></font></label><font style="vertical-align: inherit;"><span style="font-size: 12pt;"><font style="vertical-align: inherit;">&nbsp;南京醫科大學附屬第一人民醫院</font></span><label style="font-size: 9pt; font-weight: bold;"><font style="vertical-align: inherit;">（</font></label><label style="font-size: 10.5pt; font-weight: bold;"><font style="vertical-align: inherit;">組織機構編碼：</font></label><span style="color: rgb(211, 211, 211); font-size: 14px; font-weight: 700;"><font style="vertical-align: inherit;">12370600493502999Y </font></span><label style="font-size: 9pt; font-weight: bold;"><font style="vertical-align: inherit;">）</font></label></font><span style="font-size: 12pt;">
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		</span><label style="font-size: 9pt; font-weight: bold;"><font style="vertical-align: inherit;"></font></label></p><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><label style="font-size: 9pt; font-weight: bold;"><span style="font-size: 20px; text-align: start;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">住 院 病 案 首 頁</font></font></span></label></p></div>

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		</span><label style=" font-family: 宋体; font-size: 9pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">醫療付費方式：</font></font></label><span>
		</span><field tabindex="0" id="AR_FP_MEDICALPAYMENT" name="AR_FP_MEDICALPAYMENT" class="" style="font-family: 宋体; font-size: 9pt; text-align: center; display: inline-block; min-width: 150px;" type="DropdownList" data-list="[{&quot;value&quot;:&quot;1&quot;,&quot;text&quot;:&quot;1-城镇职工基本医疗保险&quot;},{&quot;value&quot;:&quot;2&quot;,&quot;text&quot;:&quot;2-城镇居民基本医疗保险&quot;},{&quot;value&quot;:&quot;3&quot;,&quot;text&quot;:&quot;3-新型农村合作医疗&quot;},{&quot;value&quot;:&quot;4&quot;,&quot;text&quot;:&quot;4-贫困救助&quot;},{&quot;value&quot;:&quot;5&quot;,&quot;text&quot;:&quot;5-商业医疗保险&quot;},{&quot;value&quot;:&quot;6&quot;,&quot;text&quot;:&quot;6-全公费&quot;},{&quot;value&quot;:&quot;7&quot;,&quot;text&quot;:&quot;7-全自费&quot;},{&quot;value&quot;:&quot;8&quot;,&quot;text&quot;:&quot;8-其他社会保险&quot;},{&quot;value&quot;:&quot;9&quot;,&quot;text&quot;:&quot;9-其他&quot;}]" value="1" title="1-城鎮職工基本醫療保險" data-code="" data-expression="" event="undefined" multi="false" validate="false" data-show-vaule="" data-show-id=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-城鎮職工基本醫療保險</font></font></field><span>&nbsp;</span></p><p style="text-align: center;"><span>
		</span><label style=" font-family: 宋体; font-size: 9pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">健康卡號：001677741400</font></font></label><font style="vertical-align: inherit;"><span style="font-size: 9pt;"><font style="vertical-align: inherit;">第</font></span></font><span>&nbsp;</span>                 <span style="font-size: 9pt;"><font style="vertical-align: inherit;"></font></span><field tabindex="0" id="patn_ipt_cnt" name="patn_ipt_cnt" type="Text" contenteditable="true" class="input" title="患者住院次數" domain="baseinfo" code="" multiline="false" required="false" format="" data-expression="" style="display: inline-block; min-width: 15px; font-size: 10.5pt;" inputmode="" value="3"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">3</font></font></field><label style="font-family: 宋体; font-size: 9pt;" domain="" code="" title=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">次住院</font></font></label><font style="vertical-align: inherit;"><label style=" font-family: 宋体; font-size: 9pt;"><font style="vertical-align: inherit;">病案號：</font></label></font><span>
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		</span><label style=" font-family: 宋体; font-size: 9pt;">  </label><span>
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		</span><label style=" font-family: 宋体; font-size: 9pt;"><font style="vertical-align: inherit;"></font><field tabindex="0" id="field_284" name="field_284" type="Text" contenteditable="true" class="input" title="文字方塊" value="N2024010100888-3" data-code="" data-expression="= &quot;N2024010100888-&quot; + patn_ipt_cnt" multiline="false" validate="false" format="" style="display: inline-block; min-width: 100px;" domain="" code="" required="false" inputmode=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">N2024010100888-3</font></font></field>&nbsp;</label></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
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		</span><table class="" id="" title="" data-field="" style="border-width: 0px; border-color: rgb(0, 0, 0);"><colgroup><col style="width: 72px;"><col style="width: 51px;"><col style="width: 104px;"><col style="width: 38px;"><col style="width: 44px;"><col style="width: 60px;"><col style="width: 56px;"><col style="width: 48px;"><col style="width: 51px;"><col style="width: 71px;"><col style="width: 15px;"><col style="width: 66px;"></colgroup><tbody style=""><tr style="height: 7.76271cm">
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		<label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">姓名：</font></font><field tabindex="0" id="patient_name" name="patient_name" type="Text" contenteditable="true" class="input" title="患者姓名" value="戴品涵" domain="" code="HDSD00.02.027" multiline="false" required="false" format="" data-expression="" inputmode=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">戴品涵</font></font></field>&nbsp;</label>&nbsp;<label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 性別：</font></font></label><field tabindex="0" class="" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" data-list="[{&quot;value&quot;:&quot;1&quot;,&quot;text&quot;:&quot;男&quot;},{&quot;value&quot;:&quot;2&quot;,&quot;text&quot;:&quot;女&quot;}]" value="2" title="體重（kg）" domain="" code="HDSD00.07.018" contenteditable="true" multi="false" required="false" data-show-vaule="" data-show-id="" id="weight" name="weight"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">女</font></font></field>
		<label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">  出生日期：</font></font></label><field tabindex="0" class="" style=" font-family: 宋体; font-size: 10.5pt;" id="birthday" name="birthday" type="DateTime" format="yyyy年MM月dd日" value="2019-01-08" title="出生日期" data-code="" validate="false" contenteditable="false" domain="" code="HDSD00.03.003" required="false"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">2019年01月08日</font></font></field>
		<label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 年齡：</font></font></label><field tabindex="0" id="nl1" name="nl1" class="" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="5岁" title="年齡" data-code="" data-expression="= GETAGE( birthday)" multiline="false" validate="false" format=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">5歲</font></font></field>&nbsp;<label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 國籍：</font></font><field tabindex="0" id="ntly" name="ntly" type="Text" contenteditable="true" class="input blank" title="國籍" domain="baseinfo" value="国籍" code="" multiline="false" required="false" format="text" data-expression="" inputmode="text"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">國籍</font></font></field></label></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">（年齡不足1歲的）年齡 </font></font></label><span>
		</span><field tabindex="0" id="nl2_y" name="nl2_y" class="" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="-" title="月齡"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">-</font></font></label></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 月 新生兒出生體重 </font></font></label><span>
		</span><field tabindex="0" id="AR_FP_BRITHWEIGHT" name="AR_FP_BRITHWEIGHT" class="" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" title="出生體重" value="2" domain="" code="" multiline="false" required="false" format="decimal" data-expression="" inputmode="decimal"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">2</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 克 新生兒入院體重</font></font></label><span style="">
		</span><field tabindex="0" id="AR_FP_INPWEIGHT" name="AR_FP_INPWEIGHT" class="" style="font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" title="入院體重" domain="" code="" multiline="false" required="false" format="number" data-expression="" value="23.44"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">23.44</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">克</font></font></label><span>
	</span></p><p style=" font-family: 宋体; font-size: 10.5pt;">
		<label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">出生地：山東省煙台市龍口市</font></font></label><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 籍貫：</font></font></label><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">山東省煙台市龍口市</font></font></label></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">身分證明類別：370729196912042329&nbsp;</font></font></label><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">職業：</font></font></label><field tabindex="0" id="PA_OCCUPATION" name="PA_OCCUPATION" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="農民" data-code="" data-expression="" event="undefined" multi="false" validate="false" data-show-vaule="" data-show-id=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">農民</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">  婚姻 </font></font></label><span>
		</span><field tabindex="0" id="PA_AMRRIAGE_STATUS" name="PA_AMRRIAGE_STATUS" class="" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" data-list="[{&quot;value&quot;:&quot;1&quot;,&quot;text&quot;:&quot;未婚&quot;},{&quot;value&quot;:&quot;2&quot;,&quot;text&quot;:&quot;已婚&quot;},{&quot;value&quot;:&quot;3&quot;,&quot;text&quot;:&quot;丧偶&quot;},{&quot;value&quot;:&quot;4&quot;,&quot;text&quot;:&quot;离婚&quot;},{&quot;value&quot;:&quot;9&quot;,&quot;text&quot;:&quot;其他&quot;}]" value="2" title="未婚" domain="" code="" contenteditable="true" multi="false" required="false" data-show-vaule="" data-show-id=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">已婚</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"> </label><span>
	</span></p><p style="font-size: 10.5pt; font-family: 宋体;" title="1" contenteditable="false"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">現住址：</font></font></label><field tabindex="0" class="" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="山东省烟台市龙口市石良镇关李家村124号" title="郵遞區號" data-code="" data-expression="" multiline="false" validate="false" format="" domain="" code="DE02.01.047.00" required="false" inputmode="" id="POSTCODE" name="POSTCODE"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">山東省煙台市龍口市石良鎮關李家村124號</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 電話：</font></font></label><field tabindex="0" id="AR_FP_CURRENT_TELEPHONE" name="AR_FP_CURRENT_TELEPHONE" class="" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="15553502541" title="電話" domain="" code="" multiline="false" required="false" format="mobile" data-expression=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">15553502541</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">  郵編 </font></font></label><span>
		</span><field tabindex="0" id="AR_FP_CURRENT_ZIP" name="AR_FP_CURRENT_ZIP" class="" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="265700" title="現住址郵編" data-code="" data-expression="" multiline="false" validate="false" format=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">265700</font></font></field><span>
	</span></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">戶口地址：</font></font></label><field tabindex="0" id="PA_RPE_ADDRESS" name="PA_RPE_ADDRESS" class="" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="山东省烟台市龙口市石良镇关李家村124号" title="戶口地址" data-code="" data-expression="" multiline="false" validate="false" format=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">山東省煙台市龍口市石良鎮關李家村124號</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 郵編 </font></font></label><span>
		</span><field tabindex="0" class="" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="265700" title="郵遞區號" data-code="" data-expression="" multiline="false" validate="false" format="" domain="" code="HDSD00.02.056" required="false" inputmode="" id="youbian" name="youbian"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">265700</font></font></field><span>
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		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">工作單位及地址 —</font></font></label><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 單位電話 </font></font></label><span>
		</span><field tabindex="0" id="PA_W_PHONE" name="PA_W_PHONE" class="" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="15553502541" title="單位電話" data-code="" data-expression="" multiline="false" validate="false" format=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">15553502541</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 郵編 </font></font></label><span>
		</span><field tabindex="0" id="PA_W_POSTALCODE" name="PA_W_POSTALCODE" class="" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="265700" title="郵編" data-code="" data-expression="" multiline="false" validate="false" format=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">265700</font></font></field><span>
	</span></p><p style="font-family: 宋体; font-size: 10.5pt;">
		<label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">聯絡人姓名：</font></font></label><field tabindex="0" id="PA_LINKMAN_NAME" name="PA_LINKMAN_NAME" class="" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="刁永进" title="" data-code="" data-expression="" multiline="false" validate="false" format=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">刁永進</font></font></field>
<label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">關係：</font></font><field tabindex="0" id="coner_rlts_code" name="coner_rlts_code" type="Text" contenteditable="true" class="input blank" title="關係代碼" value="关系代码" data-code="" data-expression="" multiline="false" validate="false" format=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">關係代碼</font></font></field>&nbsp;</label><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 地址 ：</font></font></label><field tabindex="0" id="PA_LM_ADDRESS" name="PA_LM_ADDRESS" class="" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="山东省烟台市龙口市石良镇关李家村124号" title="地址" data-code="" data-expression="" multiline="false" validate="false" format=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">山東省煙台市龍口市石良鎮關李家村124號</font></font></field>
		<label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 電話：13573552863</font></font></label></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">入院途徑 </font></font></label><span>
		</span><field tabindex="0" id="AR_FP_AL_ADMISSION" name="AR_FP_AL_ADMISSION" class="" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-急诊&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-门诊&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-其他医疗机构转入&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;9-其他&quot;,&quot;value&quot;:&quot;9&quot;}]" value="2" title="1-急診"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">2-門診</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1.急診 2.門診 3.其他醫療機構轉入,轉診醫療機構名稱</font></font></label><span>
		</span><field tabindex="0" id="ZZJGMC" name="ZZJGMC" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="轉診醫療機構名稱"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">轉診醫療機構名稱</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">  9.其他</font></font></label><span>
	</span></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">入院時間 </font></font></label><field tabindex="0" class="" style=" font-family: 宋体; font-size: 10.5pt;" id="PA_DIAGNOSE_DATE" name="PA_DIAGNOSE_DATE" type="DateTime" format="yyyy年MM月dd日 HH时" value="" title="入院時間"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">2022年04月14日08時</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 入院科別 </font></font></label><span>
		</span><field tabindex="0" id="PA_RYKB_NAME" name="PA_RYKB_NAME" class="blank" style="font-family: 宋体; font-size: 10.5pt;" type="Text" value="胸外科病房" title="胸腔外科病房" data-code="" data-expression="" event="undefined" multi="false" validate="false" data-show-vaule="" data-show-id="" domain="" code="" contenteditable="true" required="false" multiline="false" format=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">胸腔外科病房</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 病房 </font></font></label><span>
		</span><field tabindex="0" id="AR_FP_AL_HOSPITALWARDS" name="AR_FP_AL_HOSPITALWARDS" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="-" title="-" data-code="" data-expression="" multiline="false" validate="false" format=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">-</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 轉科科別 </font></font></label><span>
		</span><field tabindex="0" id="PA_DISPLACE_KB_NAME" name="PA_DISPLACE_KB_NAME" class="" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="-" title="轉科科別"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">-</font></font></label></field><span>
	</span></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">出院時間 </font></font></label><field tabindex="0" class="" style=" font-family: 宋体; font-size: 10.5pt;" id="PA_LEAVEHOSPITAL_PATIENT" name="PA_LEAVEHOSPITAL_PATIENT" type="DateTime" format="yyyy年MM月dd日 HH时" value="" title="出院時間"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">2022年04月24日07時</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 出院科別 </font></font></label><span>
		</span><field tabindex="0" id="PA_LEAVEHOSPITAL_BE_NAME" name="PA_LEAVEHOSPITAL_BE_NAME" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="Text" value="胸外科病房" title="胸腔外科病房" data-code="" data-expression="" event="undefined" multi="false" validate="false" data-show-vaule="" data-show-id="" domain="" code="" contenteditable="true" required="false"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">胸腔外科病房</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 病房 </font></font></label><span>
		</span><field tabindex="0" id="AR_FP_AL_DISCHARGEWARD" name="AR_FP_AL_DISCHARGEWARD" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="出院病房" title="出院病房"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">-</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 實際住院 </font></font></label><span>
		</span><field tabindex="0" id="SJZYTS" name="SJZYTS" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" contenteditable="true" type="Text" value="10" title="10" data-code="" data-expression="" multiline="false" validate="false" format=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">10</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 天</font></font></label><span>
	</span></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">門（急診）診診斷 </font></font></label><span>
<field tabindex="0" id="field_286" name="field_286" type="DataList" contenteditable="true" class="blank input" title="門診診斷" data="" validate="false" data-code="" data-codepos="1" code="HDSD00.11.024"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">門診診斷</font></font></field></span><span>&nbsp;</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 疾病編碼 </font></font></label><span>
		</span><field tabindex="0" id="AR_FP_AL_WM_ICD" name="AR_FP_AL_WM_ICD" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="R91.x03" title="R91.x03" data-code="" data-expression="" multiline="false" validate="false" format=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">R91.x03</font></font></field></p></td>
		</tr><tr style="height: 0.915254cm">
			<td colspan="3" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">出院診斷</font></font></label></p></td>
			<td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">疾病編碼</font></font></label></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">住院</font></font></label><span>
	</span></p><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">病情</font></font></label></p></td>
			<td colspan="3" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">出院診斷</font></font></label></p></td>
			<td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">疾病編碼</font></font></label></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">入院病情</font></font></label></p></td>
		</tr><tr>
			<td colspan="3" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">主要診斷：</font></font><field tabindex="0" id="field_260" name="field_260" type="DataList" contenteditable="true" class="input" title="主要診斷" data="" validate="false" data-code="" data-codepos="1" value="F61.x00x001" data-text="混合型人格障碍" code="HDSD00.11.024"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">混合型人格障礙</font></font></field>&nbsp;</label></p></td>
			<td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd0_bm" name="zd0_bm" class="" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="F61.x00x001" title="疾病編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">F61.x00x001</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd0_bq" name="zd0_bq" class="" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-临床未确定&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-情况不明&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-无&quot;,&quot;value&quot;:&quot;4&quot;}]" value="1" title="1-有"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-有</font></font></field></p></td>
			<td colspan="3" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">其他診斷</font></font></label><span>&nbsp;<!--StartFragment--><field tabindex="0" id="field_261" name="field_261" type="DataList" contenteditable="true" class="input" title="其他診斷" data="" validate="false" data-code="" data-codepos="1" value="L74.300" data-text="痱"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">痱</font></font></field>&nbsp;<!--EndFragment-->

</span></p></td>
			<td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd11_bm" name="zd11_bm" class="" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="L74.300" title="疾病編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">L74.300</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd11_bq" name="zd11_bq" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-临床未确定&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-情况不明&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-无&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-有"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-有</font></font></field></p></td>
		</tr><tr style="height: 26px">
			<td colspan="3" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">其他診斷：</font></font><field tabindex="0" id="field_261" name="field_261" type="DataList" contenteditable="true" class="input" title="其他診斷" data="" validate="false" data-code="" data-codepos="1" value="F60.800x001" data-text="情感性人格" code="HDSD00.11.024"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">情感性人格</font></font></field>&nbsp;</label></p></td>
			<td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd1_bm" name="zd1_bm" class="" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="疾病編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">F60.800x001</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd1_bq" name="zd1_bq" class="" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-临床未确定&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-情况不明&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-无&quot;,&quot;value&quot;:&quot;4&quot;}]" value="1" title="1-有"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-有</font></font></field></p></td><td colspan="3" class="" style="border-color: rgb(0, 0, 0)"><p style=" font-family: 宋体; font-size: 10.5pt;"><field tabindex="0" id="zd12_mc" name="zd12_mc" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="診斷訊息">

<!--StartFragment--><field tabindex="0" id="field_261" name="field_261" type="DataList" contenteditable="true" class="input" title="診斷訊息" data="" validate="false" data-code="" data-codepos="1" value="J34.800x031" data-text="鼻瘘"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">鼻瘻</font></font></field><!--EndFragment-->

</field></p></td>
			<td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd12_bm" name="zd12_bm" class="" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="J34.800x031" title="疾病編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">J34.800x031</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd12_bq" name="zd12_bq" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-临床未确定&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-情况不明&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-无&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-有"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-有</font></font></field></p></td>
		</tr><tr style="height: 26px">
			<td colspan="3" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span>

<!--StartFragment--><field tabindex="0" id="zd2_bq" name="zd2_bq" class="" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-临床未确定&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-情况不明&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-无&quot;,&quot;value&quot;:&quot;4&quot;}]" value="1" title="1-有"></field>
			<span>
	</span><span>
		</span>

<!--StartFragment--><field tabindex="0" id="field_261" name="field_261" type="DataList" contenteditable="true" class="input blank" title="診斷訊息" data="" validate="false" data-code="" data-codepos="1" style=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">診斷訊息</font></font></field></td>
			<td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd3_bm" name="zd3_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="疾病編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">疾病編碼</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd4_bq" name="zd4_bq" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-临床未确定&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-情况不明&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-无&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-有"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-有</font></font></field></p></td>
			<td colspan="3" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span>

<!--StartFragment-->

<!--StartFragment--><field tabindex="0" id="field_266" name="field_266" type="DataList" contenteditable="true" class="input" title="診斷訊息" data="" validate="false" data-code="" data-codepos="0" style="" value="M80100/3" text="癌"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">癌症</font></font></field></td>
			<td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd14_bm" name="zd14_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="疾病編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">疾病編碼</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd14_bq" name="zd14_bq" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-临床未确定&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-情况不明&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-无&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-有"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-有</font></font></field></p></td>
		</tr><tr class="" style="height: 26px"><td colspan="3" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span>

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<!--StartFragment--><field tabindex="0" id="field_266" name="field_266" type="DataList" contenteditable="true" class="input" title="診斷訊息" data="" validate="false" data-code="" data-codepos="0" style="" value="K46.900x011" text="疝"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">疝</font></font></field></td><td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
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<!--StartFragment--><field tabindex="0" id="field_266" name="field_266" type="DataList" contenteditable="true" class="blank input" title="診斷訊息" data="" validate="false" data-code="" data-codepos="0" style=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">診斷訊息</font></font></field></td><td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
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<!--StartFragment--><field tabindex="0" id="field_266" name="field_266" type="DataList" contenteditable="true" class="blank input" title="診斷訊息" data="" validate="false" data-code="" data-codepos="0" style=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">診斷訊息</font></font></field></td><td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
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<!--StartFragment--><field tabindex="0" id="field_266" name="field_266" type="DataList" contenteditable="true" class="blank input" title="診斷訊息" data="" validate="false" data-code="" data-codepos="0" style=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">診斷訊息</font></font></field></td><td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
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	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd14_bm" name="zd14_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="疾病編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">疾病編碼</font></font></field></p></td><td colspan="1" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd14_bq" name="zd14_bq" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-临床未确定&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-情况不明&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-无&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-有"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-有</font></font></field></p></td></tr><tr class=""><td colspan="3" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span>

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			<span>
	</span><span>
		</span>

<!--StartFragment--><field tabindex="0" id="field_261" name="field_261" type="DataList" contenteditable="true" class="input blank" title="診斷訊息" data="" validate="false" data-code="" data-codepos="1" style=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">診斷訊息</font></font></field></td><td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd3_bm" name="zd3_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="疾病編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">疾病編碼</font></font></field></p></td><td colspan="1" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd4_bq" name="zd4_bq" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-临床未确定&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-情况不明&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-无&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-有"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-有</font></font></field></p></td><td colspan="3" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span>

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<!--StartFragment--><field tabindex="0" id="field_266" name="field_266" type="DataList" contenteditable="true" class="blank input" title="診斷訊息" data="" validate="false" data-code="" data-codepos="0" style=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">診斷訊息</font></font></field></td><td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd14_bm" name="zd14_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="疾病編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">疾病編碼</font></font></field></p></td><td colspan="1" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd14_bq" name="zd14_bq" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-临床未确定&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-情况不明&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-无&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-有"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-有</font></font></field></p></td></tr><tr class=""><td colspan="3" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span>

<!--StartFragment--><field tabindex="0" id="zd2_bq" name="zd2_bq" class="" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-临床未确定&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-情况不明&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-无&quot;,&quot;value&quot;:&quot;4&quot;}]" value="1" title="1-有"></field>
			<span>
	</span><span>
		</span>

<!--StartFragment--><field tabindex="0" id="field_261" name="field_261" type="DataList" contenteditable="true" class="input blank" title="診斷訊息" data="" validate="false" data-code="" data-codepos="1" style=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">診斷訊息</font></font></field></td><td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd3_bm" name="zd3_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="疾病編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">疾病編碼</font></font></field></p></td><td colspan="1" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd4_bq" name="zd4_bq" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-临床未确定&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-情况不明&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-无&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-有"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-有</font></font></field></p></td><td colspan="3" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span>

<!--StartFragment-->

<!--StartFragment--><field tabindex="0" id="field_266" name="field_266" type="DataList" contenteditable="true" class="blank input" title="診斷訊息" data="" validate="false" data-code="" data-codepos="0" style=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">診斷訊息</font></font></field></td><td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd14_bm" name="zd14_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="疾病編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">疾病編碼</font></font></field></p></td><td colspan="1" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd14_bq" name="zd14_bq" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-临床未确定&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-情况不明&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-无&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-有"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-有</font></font></field></p></td></tr><tr class=""><td colspan="3" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span>

<!--StartFragment--><field tabindex="0" id="zd2_bq" name="zd2_bq" class="" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-临床未确定&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-情况不明&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-无&quot;,&quot;value&quot;:&quot;4&quot;}]" value="1" title="1-有"></field>
			<span>
	</span><span>
		</span>

<!--StartFragment--><field tabindex="0" id="field_261" name="field_261" type="DataList" contenteditable="true" class="input blank" title="診斷訊息" data="" validate="false" data-code="" data-codepos="1" style=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">診斷訊息</font></font></field></td><td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd3_bm" name="zd3_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="疾病編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">疾病編碼</font></font></field></p></td><td colspan="1" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd4_bq" name="zd4_bq" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-临床未确定&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-情况不明&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-无&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-有"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-有</font></font></field></p></td><td colspan="3" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span>

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<!--StartFragment--><field tabindex="0" id="field_266" name="field_266" type="DataList" contenteditable="true" class="blank input" title="診斷訊息" data="" validate="false" data-code="" data-codepos="0" style=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">診斷訊息</font></font></field></td><td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd14_bm" name="zd14_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="疾病編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">疾病編碼</font></font></field></p></td><td colspan="1" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd14_bq" name="zd14_bq" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-临床未确定&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-情况不明&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-无&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-有"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-有</font></font></field></p></td></tr><tr class=""><td colspan="3" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span>

<!--StartFragment--><field tabindex="0" id="zd2_bq" name="zd2_bq" class="" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-临床未确定&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-情况不明&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-无&quot;,&quot;value&quot;:&quot;4&quot;}]" value="1" title="1-有"></field>
			<span>
	</span><span>
		</span>

<!--StartFragment--><field tabindex="0" id="field_261" name="field_261" type="DataList" contenteditable="true" class="input blank" title="診斷訊息" data="" validate="false" data-code="" data-codepos="1" style=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">診斷訊息</font></font></field></td><td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd3_bm" name="zd3_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="疾病編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">疾病編碼</font></font></field></p></td><td colspan="1" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd4_bq" name="zd4_bq" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-临床未确定&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-情况不明&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-无&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-有"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-有</font></font></field></p></td><td colspan="3" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span>

<!--StartFragment-->

<!--StartFragment--><field tabindex="0" id="field_266" name="field_266" type="DataList" contenteditable="true" class="blank input" title="診斷訊息" data="" validate="false" data-code="" data-codepos="0" style=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">診斷訊息</font></font></field></td><td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd14_bm" name="zd14_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="疾病編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">疾病編碼</font></font></field></p></td><td colspan="1" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd14_bq" name="zd14_bq" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-临床未确定&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-情况不明&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-无&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-有"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-有</font></font></field></p></td></tr><tr>
			<td colspan="6" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">入院病情：1.有，2.臨床未確定，3.情況不明，4.無</font></font></label></p></td>
			<td colspan="3" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd22_mc" name="zd22_mc" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="診斷訊息"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">診斷訊息</font></font></field></p></td>
			<td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd22_bm" name="zd22_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="疾病編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">疾病編碼</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="zd22_bq" name="zd22_bq" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-临床未确定&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-情况不明&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-无&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-有"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-有</font></font></field></p></td>
		</tr><tr style="height: 0.79661cm">
			<td colspan="12" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Justify;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">損傷、 中毒的外在原因 </font></font></label><span>
		</span><field tabindex="0" id="zd24_mc" name="zd24_mc" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="-" data-code="" data-expression="" event="undefined" multi="false" validate="false" data-show-vaule="" data-show-id=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">-</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 疾病編碼 </font></font></label><span>
		</span><field tabindex="0" id="zd24_bm" name="zd24_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="中毒疾病編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">中毒疾病編碼</font></font></field></p></td>
		</tr><tr style="height: 1.07627cm">
			<td colspan="12" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">病理診斷：</font></font></label><span>
		</span><field tabindex="0" id="zd25_mc" name="zd25_mc" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="腺癌" data-code="" data-expression="" event="undefined" multi="false" validate="false" data-show-vaule="" data-show-id=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">腺癌</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 疾病編碼 </font></font></label><span>
		</span><field tabindex="0" id="zd25_bm" name="zd25_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="病理疾病编码" title="病理疾病編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">M81400/3</font></font></field><span></span></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><field tabindex="0" id="AR_FP_AFTER_PATHOLOGY_REULT" name="AR_FP_AFTER_PATHOLOGY_REULT" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title=""></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"> </label><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">病理號 </font></font></label><span>
		</span><field tabindex="0" id="AR_FP_AFTER_PATHOLOGY" name="AR_FP_AFTER_PATHOLOGY" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="病理号" title="202224179" data-code="" data-expression="" multiline="false" validate="false" format=""><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">202224179</font></font></field><span>&nbsp;</span></p></td>
		</tr><tr style="height: 0.635593cm">
			<td colspan="12" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Justify;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">最高診斷依據</font></font></label><span>
		</span><field tabindex="0" id="ZGZDYJ" name="ZGZDYJ" class="" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;病理(包括细胞学、尸检)&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;手术&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;内镜&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;血管造影&quot;,&quot;value&quot;:&quot;4&quot;},{&quot;text&quot;:&quot;MR&quot;,&quot;value&quot;:&quot;5&quot;},{&quot;text&quot;:&quot;CT&quot;,&quot;value&quot;:&quot;6&quot;},{&quot;text&quot;:&quot;X线&quot;,&quot;value&quot;:&quot;7&quot;},{&quot;text&quot;:&quot;超声&quot;,&quot;value&quot;:&quot;8&quot;},{&quot;text&quot;:&quot;心电图&quot;,&quot;value&quot;:&quot;9&quot;},{&quot;text&quot;:&quot;生化、免疫&quot;,&quot;value&quot;:&quot;10&quot;},{&quot;text&quot;:&quot;临床表现&quot;,&quot;value&quot;:&quot;11&quot;},{&quot;text&quot;:&quot;其他&quot;,&quot;value&quot;:&quot;12&quot;}]" value="病理(包括细胞学" title="病理(包括細胞學"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">病理(包括細胞學</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">藥物過敏 </font></font></label><span>
		</span><field tabindex="0" id="AR_FP_ALLERGICCONTENT" name="AR_FP_ALLERGICCONTENT" class="" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-无&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-有&quot;,&quot;value&quot;:&quot;2&quot;}]" value="1" title="1-無"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-無</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1.無2.有 過敏藥物：</font></font></label><span>
		</span><field tabindex="0" id="AR_FP_ALLERGICCONTENT_MED" name="AR_FP_ALLERGICCONTENT_MED" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="過敏藥物"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">過敏藥物</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 死亡患者屍檢 </font></font></label><span>
		</span><field tabindex="0" id="AR_FP_ANAUTOPSY" name="AR_FP_ANAUTOPSY" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-是&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-否&quot;,&quot;value&quot;:&quot;2&quot;}]" value="" title="1-是"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-是</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1.是2.否</font></font></label></p></td>
		</tr><tr style="height: 0.686441cm">
			<td colspan="12" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Justify;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">血型  </font></font></label><span>
		</span><field tabindex="0" id="AR_FP_BLOOD" name="AR_FP_BLOOD" class="" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-A&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-B&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-O&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-AB&quot;,&quot;value&quot;:&quot;4&quot;},{&quot;text&quot;:&quot;5-不详&quot;,&quot;value&quot;:&quot;5&quot;},{&quot;text&quot;:&quot;6-未查&quot;,&quot;value&quot;:&quot;6&quot;}]" value="1" title="1-A"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-A</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1.A 2.B 3.O 4.AB 5.不詳 6.未查 Rh </font></font></label><span>
		</span><field tabindex="0" id="AR_FP_RH" name="AR_FP_RH" class="" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-阴&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-阳&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-不详&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-未查&quot;,&quot;value&quot;:&quot;4&quot;}]" value="2" title="1-陰"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">2-陽</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">  1.陰 2.陽 3.不詳 4.未查</font></font></label></p></td>
		</tr><tr style="height: 1.36441cm">
			<td colspan="12" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Justify;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">科主任</font></font></label><span>
		</span><field tabindex="0" id="AR_FP_DIRECTOR" name="AR_FP_DIRECTOR" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="科主任"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">科主任</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 醫療組長</font></font></label><span>
		</span><field tabindex="0" id="YLZZ" name="YLZZ" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="組長"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">組長</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 主任（副主任）</font></font></label><label style="font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">醫師 </font></font></label><span style="font-size: 10.5pt;">
		</span><field tabindex="0" id="AR_FP_INTERN" name="AR_FP_INTERN" class="blank" type="DropdownList" value="" title="實習醫師" style="font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">實習醫師</font></font></field><span style="font-size: 10.5pt;">
		</span><label style="font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 編碼員 </font></font></label><span style="font-size: 10.5pt;">
		</span><field tabindex="0" id="AR_FP_CODERS" name="AR_FP_CODERS" class="blank" type="DropdownList" value="" title="編碼員" style="font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">編碼員</font></font></field></p></td>
		</tr><tr style="height: 0.847458cm">
			<td colspan="12" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Justify;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">病案品質 </font></font></label><span>
		</span><field tabindex="0" id="AR_FP_MEDICALQUALITY" name="AR_FP_MEDICALQUALITY" class="" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-甲&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-乙&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-丙&quot;,&quot;value&quot;:&quot;3&quot;}]" value="1" title="1-甲"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-甲</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1.甲 2.乙 3.丙 品管醫師 </font></font></label><span>
		</span><field tabindex="0" id="AR_FP_QCPHYSICIANS" name="AR_FP_QCPHYSICIANS" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="品管醫師"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">品管醫師</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 品管護士 </font></font></label><span>
		</span><field tabindex="0" id="AR_FP_QCNURSES" name="AR_FP_QCNURSES" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="品管護士"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">品管護士</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 日期 </font></font></label><field tabindex="0" class="" style=" font-family: 宋体; font-size: 10.5pt;" id="AR_FP_RSDATE" name="AR_FP_RSDATE" type="DateTime" format="yyyy年MM月dd日" value="" title="品控日期"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">2022年04月24日</font></font></field></p></td>
		</tr><tr>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">手術及</font></font></label><span>
	</span></p><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">操作編碼</font></font></label></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">手術及</font></font></label><span>
	</span></p><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">操作日期</font></font></label></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">手術及操作名稱</font></font></label></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">手術等級</font></font></label></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">擇期/急診</font></font></label></p></td>
			<td colspan="3" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">手術及操作醫師</font></font></label></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">切口癒合等級</font></font></label></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">麻醉方式</font></font></label></p></td>
			<td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">麻醉醫師</font></font></label></p></td>
		</tr><tr>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=""></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=""></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=""></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=""></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=""></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">術者</font></font></label></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">Ⅰ助</font></font></label></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">Ⅱ助</font></font></label></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=""></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=""></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=""></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=""></p></td>
		</tr><tr>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss0_bm" name="ss0_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">編碼</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><field tabindex="0" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" id="ss0_rq" name="ss0_rq" type="DateTime" format="yyyyMMdd" value="" title="日期"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">日期</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss0_mc" name="ss0_mc" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="手術名稱"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">手術名稱</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss0_ssjb" name="ss0_ssjb" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-一级手术&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-二级手术&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-三级手术&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-四级手术&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-一級手術"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-一級手術</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss0_zqjz" name="ss0_zqjz" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;择期&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;急症&quot;,&quot;value&quot;:&quot;2&quot;}]" value="" title="擇期"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">擇期</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss0_sz" name="ss0_sz" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="術者"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">術者</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss0_yz" name="ss0_yz" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="Ⅰ助"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">Ⅰ助</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss0_ez" name="ss0_ez" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="Ⅱ助"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">Ⅱ助</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss0_qkyh" name="ss0_qkyh" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;0&quot;},{&quot;text&quot;:&quot;Ⅰ/甲&quot;},{&quot;text&quot;:&quot;Ⅱ/甲&quot;},{&quot;text&quot;:&quot;Ⅲ/甲&quot;},{&quot;text&quot;:&quot;Ⅰ/乙&quot;},{&quot;text&quot;:&quot;Ⅱ/乙&quot;},{&quot;text&quot;:&quot;Ⅲ/乙&quot;},{&quot;text&quot;:&quot;Ⅰ/丙&quot;},{&quot;text&quot;:&quot;Ⅱ/丙&quot;},{&quot;text&quot;:&quot;Ⅲ/丙&quot;},{&quot;text&quot;:&quot;Ⅰ/其他&quot;},{&quot;text&quot;:&quot;Ⅱ/其他&quot;},{&quot;text&quot;:&quot;Ⅲ/其他&quot;}]" value="" title="0"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">0</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss0_mzfs" name="ss0_mzfs" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="麻醉方式"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">麻醉方式</font></font></field></p></td>
			<td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss0_mzys" name="ss0_mzys" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="麻醉醫師"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">麻醉醫師</font></font></field></p></td>
		</tr><tr style="height: 0.690678cm">
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss1_bm" name="ss1_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">編碼</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><field tabindex="0" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" id="ss1_rq" name="ss1_rq" type="DateTime" format="yyyyMMdd" value="" title="日期"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">日期</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss1_mc" name="ss1_mc" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="手術名稱"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">手術名稱</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss1_ssjb" name="ss1_ssjb" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-一级手术&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-二级手术&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-三级手术&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-四级手术&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-一級手術"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-一級手術</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss1_zqjz" name="ss1_zqjz" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;择期&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;急症&quot;,&quot;value&quot;:&quot;2&quot;}]" value="" title="擇期"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">擇期</font></font></field></p></td>
			<td id="" title="" class="" style="border-color: rgb(0, 0, 0); background-color: rgb(255, 255, 255); vertical-align: middle; text-align: left"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss1_sz" name="ss1_sz" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="術者"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">術者</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss1_yz" name="ss1_yz" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="Ⅰ助"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">Ⅰ助</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss1_ez" name="ss1_ez" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="Ⅱ助"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">Ⅱ助</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss1_qkyh" name="ss1_qkyh" class="" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;0&quot;},{&quot;text&quot;:&quot;Ⅰ/甲&quot;},{&quot;text&quot;:&quot;Ⅱ/甲&quot;},{&quot;text&quot;:&quot;Ⅲ/甲&quot;},{&quot;text&quot;:&quot;Ⅰ/乙&quot;},{&quot;text&quot;:&quot;Ⅱ/乙&quot;},{&quot;text&quot;:&quot;Ⅲ/乙&quot;},{&quot;text&quot;:&quot;Ⅰ/丙&quot;},{&quot;text&quot;:&quot;Ⅱ/丙&quot;},{&quot;text&quot;:&quot;Ⅲ/丙&quot;},{&quot;text&quot;:&quot;Ⅰ/其他&quot;},{&quot;text&quot;:&quot;Ⅱ/其他&quot;},{&quot;text&quot;:&quot;Ⅲ/其他&quot;}]" value="/" title="/"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">/</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss1_mzfs" name="ss1_mzfs" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="麻醉方式"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">麻醉方式</font></font></field></p></td>
			<td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss1_mzys" name="ss1_mzys" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="麻醉醫師"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">麻醉醫師</font></font></field></p></td>
		</tr><tr>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss2_bm" name="ss2_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">編碼</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><field tabindex="0" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" id="ss2_rq" name="ss2_rq" type="DateTime" format="yyyyMMdd" value="" title="日期"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">日期</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss2_mc" name="ss2_mc" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="手術名稱"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">手術名稱</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss2_ssjb" name="ss2_ssjb" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-一级手术&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-二级手术&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-三级手术&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-四级手术&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-一級手術"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-一級手術</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss2_zqjz" name="ss2_zqjz" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;择期&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;急症&quot;,&quot;value&quot;:&quot;2&quot;}]" value="" title="擇期"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">擇期</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss2_sz" name="ss2_sz" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="術者"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">術者</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss2_yz" name="ss2_yz" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="Ⅰ助"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">Ⅰ助</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss2_ez" name="ss2_ez" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="Ⅱ助"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">Ⅱ助</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss2_qkyh" name="ss2_qkyh" class="" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;0&quot;},{&quot;text&quot;:&quot;Ⅰ/甲&quot;},{&quot;text&quot;:&quot;Ⅱ/甲&quot;},{&quot;text&quot;:&quot;Ⅲ/甲&quot;},{&quot;text&quot;:&quot;Ⅰ/乙&quot;},{&quot;text&quot;:&quot;Ⅱ/乙&quot;},{&quot;text&quot;:&quot;Ⅲ/乙&quot;},{&quot;text&quot;:&quot;Ⅰ/丙&quot;},{&quot;text&quot;:&quot;Ⅱ/丙&quot;},{&quot;text&quot;:&quot;Ⅲ/丙&quot;},{&quot;text&quot;:&quot;Ⅰ/其他&quot;},{&quot;text&quot;:&quot;Ⅱ/其他&quot;},{&quot;text&quot;:&quot;Ⅲ/其他&quot;}]" value="/" title="/"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">/</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss2_mzfs" name="ss2_mzfs" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="麻醉方式"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">麻醉方式</font></font></field></p></td>
			<td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss2_mzys" name="ss2_mzys" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="麻醉醫師"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">麻醉醫師</font></font></field></p></td>
		</tr><tr>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss3_bm" name="ss3_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">編碼</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><field tabindex="0" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" id="ss3_rq" name="ss3_rq" type="DateTime" format="yyyyMMdd" value="" title="日期"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">日期</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss3_mc" name="ss3_mc" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="手術名稱"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">手術名稱</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss3_ssjb" name="ss3_ssjb" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-一级手术&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-二级手术&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-三级手术&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-四级手术&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-一級手術"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-一級手術</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss3_zqjz" name="ss3_zqjz" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;择期&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;急症&quot;,&quot;value&quot;:&quot;2&quot;}]" value="" title="擇期"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">擇期</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss3_sz" name="ss3_sz" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="術者"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">術者</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss3_yz" name="ss3_yz" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="Ⅰ助"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">Ⅰ助</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss3_ez" name="ss3_ez" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="Ⅱ助"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">Ⅱ助</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss3_qkyh" name="ss3_qkyh" class="" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;0&quot;},{&quot;text&quot;:&quot;Ⅰ/甲&quot;},{&quot;text&quot;:&quot;Ⅱ/甲&quot;},{&quot;text&quot;:&quot;Ⅲ/甲&quot;},{&quot;text&quot;:&quot;Ⅰ/乙&quot;},{&quot;text&quot;:&quot;Ⅱ/乙&quot;},{&quot;text&quot;:&quot;Ⅲ/乙&quot;},{&quot;text&quot;:&quot;Ⅰ/丙&quot;},{&quot;text&quot;:&quot;Ⅱ/丙&quot;},{&quot;text&quot;:&quot;Ⅲ/丙&quot;},{&quot;text&quot;:&quot;Ⅰ/其他&quot;},{&quot;text&quot;:&quot;Ⅱ/其他&quot;},{&quot;text&quot;:&quot;Ⅲ/其他&quot;}]" value="/" title="/"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">/</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss3_mzfs" name="ss3_mzfs" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="麻醉方式"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">麻醉方式</font></font></field></p></td>
			<td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss3_mzys" name="ss3_mzys" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="麻醉醫師"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">麻醉醫師</font></font></field></p></td>
		</tr><tr>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss4_bm" name="ss4_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">編碼</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><field tabindex="0" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" id="ss4_rq" name="ss4_rq" type="DateTime" format="yyyyMMdd" value="" title="日期"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">日期</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss4_mc" name="ss4_mc" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="手術名稱"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">手術名稱</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss4_ssjb" name="ss4_ssjb" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-一级手术&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-二级手术&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-三级手术&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-四级手术&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-一級手術"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-一級手術</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss4_zqjz" name="ss4_zqjz" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;择期&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;急症&quot;,&quot;value&quot;:&quot;2&quot;}]" value="" title="擇期"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">擇期</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss4_sz" name="ss4_sz" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="術者"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">術者</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss4_yz" name="ss4_yz" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="Ⅰ助"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">Ⅰ助</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss4_ez" name="ss4_ez" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="Ⅱ助"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">Ⅱ助</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss4_qkyh" name="ss4_qkyh" class="" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;0&quot;},{&quot;text&quot;:&quot;Ⅰ/甲&quot;},{&quot;text&quot;:&quot;Ⅱ/甲&quot;},{&quot;text&quot;:&quot;Ⅲ/甲&quot;},{&quot;text&quot;:&quot;Ⅰ/乙&quot;},{&quot;text&quot;:&quot;Ⅱ/乙&quot;},{&quot;text&quot;:&quot;Ⅲ/乙&quot;},{&quot;text&quot;:&quot;Ⅰ/丙&quot;},{&quot;text&quot;:&quot;Ⅱ/丙&quot;},{&quot;text&quot;:&quot;Ⅲ/丙&quot;},{&quot;text&quot;:&quot;Ⅰ/其他&quot;},{&quot;text&quot;:&quot;Ⅱ/其他&quot;},{&quot;text&quot;:&quot;Ⅲ/其他&quot;}]" value="/" title="/"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">/</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss4_mzfs" name="ss4_mzfs" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="麻醉方式"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">麻醉方式</font></font></field></p></td>
			<td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss4_mzys" name="ss4_mzys" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="麻醉醫師"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">麻醉醫師</font></font></field></p></td>
		</tr><tr>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss5_bm" name="ss5_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="编码" title="編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">編碼</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><field tabindex="0" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" id="ss5_rq" name="ss5_rq" type="DateTime" format="yyyyMMdd" value="" title="日期"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">日期</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss5_mc" name="ss5_mc" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="手術名稱"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">手術名稱</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss5_ssjb" name="ss5_ssjb" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-一级手术&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-二级手术&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-三级手术&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-四级手术&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-一級手術"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-一級手術</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss5_zqjz" name="ss5_zqjz" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;择期&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;急症&quot;,&quot;value&quot;:&quot;2&quot;}]" value="" title="擇期"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">擇期</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss5_sz" name="ss5_sz" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="術者"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">術者</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss5_yz" name="ss5_yz" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="Ⅰ助"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">Ⅰ助</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss5_ez" name="ss5_ez" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="Ⅱ助"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">Ⅱ助</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss5_qkyh" name="ss5_qkyh" class="" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;0&quot;},{&quot;text&quot;:&quot;Ⅰ/甲&quot;},{&quot;text&quot;:&quot;Ⅱ/甲&quot;},{&quot;text&quot;:&quot;Ⅲ/甲&quot;},{&quot;text&quot;:&quot;Ⅰ/乙&quot;},{&quot;text&quot;:&quot;Ⅱ/乙&quot;},{&quot;text&quot;:&quot;Ⅲ/乙&quot;},{&quot;text&quot;:&quot;Ⅰ/丙&quot;},{&quot;text&quot;:&quot;Ⅱ/丙&quot;},{&quot;text&quot;:&quot;Ⅲ/丙&quot;},{&quot;text&quot;:&quot;Ⅰ/其他&quot;},{&quot;text&quot;:&quot;Ⅱ/其他&quot;},{&quot;text&quot;:&quot;Ⅲ/其他&quot;}]" value="/" title="/"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">/</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss5_mzfs" name="ss5_mzfs" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="麻醉方式"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">麻醉方式</font></font></field></p></td>
			<td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss5_mzys" name="ss5_mzys" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="麻醉醫師"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">麻醉醫師</font></font></field></p></td>
		</tr><tr>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss6_bm" name="ss6_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">編碼</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><field tabindex="0" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" id="ss6_rq" name="ss6_rq" type="DateTime" format="yyyyMMdd" value="" title="日期"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">日期</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss6_mc" name="ss6_mc" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="手術名稱"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">手術名稱</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss6_ssjb" name="ss6_ssjb" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-一级手术&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-二级手术&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-三级手术&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-四级手术&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-一級手術"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-一級手術</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss6_zqjz" name="ss6_zqjz" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;择期&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;急症&quot;,&quot;value&quot;:&quot;2&quot;}]" value="" title="擇期"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">擇期</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="SSJZZYS_SS7" name="SSJZZYS_SS7" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="術者"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">術者</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss6_yz" name="ss6_yz" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="Ⅰ助"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">Ⅰ助</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss6_ez" name="ss6_ez" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="Ⅱ助"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">Ⅱ助</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss6_qkyh" name="ss6_qkyh" class="" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;0&quot;},{&quot;text&quot;:&quot;Ⅰ/甲&quot;},{&quot;text&quot;:&quot;Ⅱ/甲&quot;},{&quot;text&quot;:&quot;Ⅲ/甲&quot;},{&quot;text&quot;:&quot;Ⅰ/乙&quot;},{&quot;text&quot;:&quot;Ⅱ/乙&quot;},{&quot;text&quot;:&quot;Ⅲ/乙&quot;},{&quot;text&quot;:&quot;Ⅰ/丙&quot;},{&quot;text&quot;:&quot;Ⅱ/丙&quot;},{&quot;text&quot;:&quot;Ⅲ/丙&quot;},{&quot;text&quot;:&quot;Ⅰ/其他&quot;},{&quot;text&quot;:&quot;Ⅱ/其他&quot;},{&quot;text&quot;:&quot;Ⅲ/其他&quot;}]" value="/" title="/"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">/</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss6_mzfs" name="ss6_mzfs" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="麻醉方式"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">麻醉方式</font></font></field></p></td>
			<td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss6_mzys" name="ss6_mzys" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="麻醉醫師"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">麻醉醫師</font></font></field></p></td>
		</tr><tr>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss7_bm" name="ss7_bm" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">編碼</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><field tabindex="0" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" id="ss7_rq" name="ss7_rq" type="DateTime" format="yyyyMMdd" value="" title="日期"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">日期</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss7_mc" name="ss7_mc" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="手術名稱"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">手術名稱</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss7_ssjb" name="ss7_ssjb" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-一级手术&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-二级手术&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-三级手术&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-四级手术&quot;,&quot;value&quot;:&quot;4&quot;}]" value="" title="1-一級手術"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-一級手術</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss7_zqjz" name="ss7_zqjz" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;择期&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;急症&quot;,&quot;value&quot;:&quot;2&quot;}]" value="" title="擇期"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">擇期</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="SSJZZYS_SS8" name="SSJZZYS_SS8" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="術者"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">術者</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss7_yz" name="ss7_yz" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="Ⅰ助"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">Ⅰ助</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss7_ez" name="ss7_ez" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="Ⅱ助"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">Ⅱ助</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss7_qkyh" name="ss7_qkyh" class="" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;0&quot;},{&quot;text&quot;:&quot;Ⅰ/甲&quot;},{&quot;text&quot;:&quot;Ⅱ/甲&quot;},{&quot;text&quot;:&quot;Ⅲ/甲&quot;},{&quot;text&quot;:&quot;Ⅰ/乙&quot;},{&quot;text&quot;:&quot;Ⅱ/乙&quot;},{&quot;text&quot;:&quot;Ⅲ/乙&quot;},{&quot;text&quot;:&quot;Ⅰ/丙&quot;},{&quot;text&quot;:&quot;Ⅱ/丙&quot;},{&quot;text&quot;:&quot;Ⅲ/丙&quot;},{&quot;text&quot;:&quot;Ⅰ/其他&quot;},{&quot;text&quot;:&quot;Ⅱ/其他&quot;},{&quot;text&quot;:&quot;Ⅲ/其他&quot;}]" value="/" title="/"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">/</font></font></field></p></td>
			<td class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss7_mzfs" name="ss7_mzfs" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="麻醉方式"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">麻醉方式</font></font></field></p></td>
			<td colspan="2" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;"><span>
		</span><field tabindex="0" id="ss7_mzys" name="ss7_mzys" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="麻醉醫師"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">麻醉醫師</font></font></field></p></td>
		</tr><tr style="height: 0.881356cm">
			<td colspan="12" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">臨床路徑：入徑狀況</font></font></label><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"> </label><span>
		</span><field tabindex="0" id="RJQK" name="RJQK" class="" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-是&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-否&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;-空&quot;,&quot;value&quot;:&quot;-&quot;}]" value="-" title="-空"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">-空</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1.是 2.否 完成情況 </font></font></label><span>
		</span><field tabindex="0" id="WCQK" name="WCQK" class="" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-完成&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-退出&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;-空&quot;,&quot;value&quot;:&quot;-&quot;}]" value="-" title="-空"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">-空</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">  1.完成 2.</font></font></label><font style="vertical-align: inherit;"><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;">退出  </font></label><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;">變異狀況 </font></label></font><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"></font></label><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"></font></label><span>
		</span><field tabindex="0" id="BYQK" name="BYQK" class="" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-无&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;-空&quot;,&quot;value&quot;:&quot;-&quot;}]" value="-" title="-空"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">-空</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">  1.有 2.</font></font></label><font style="vertical-align: inherit;"><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;">無</font></label></font><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"></font></label></p></td>
		</tr><tr style="height: 1.23729cm">
			<td colspan="12" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">離院方式 </font></font></label><span>
		</span><field tabindex="0" id="AR_FP_OUTHOASPITAL_TYPE" name="AR_FP_OUTHOASPITAL_TYPE" class="" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-医嘱离院&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-医嘱转院&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-医嘱转社区卫生服务机构/乡镇卫生院&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-非医嘱离院&quot;,&quot;value&quot;:&quot;4&quot;},{&quot;text&quot;:&quot;5-死亡&quot;,&quot;value&quot;:&quot;5&quot;},{&quot;text&quot;:&quot;9-其他&quot;,&quot;value&quot;:&quot;9&quot;}]" value="1" title="1-醫囑離院"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-醫囑離院</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1.醫囑離院 2.醫囑轉院，擬接收機構名稱：</font></font></label><span>
		</span><field tabindex="0" id="AR_FP_RECEPT_UNIT" name="AR_FP_RECEPT_UNIT" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="擬接收機構名稱"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">擬接收機構名稱</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 非醫囑轉院</font></font></label><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"> </label><span>
		</span><field tabindex="0" id="FYZZY" name="FYZZY" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;—-—&quot;,&quot;value&quot;:&quot;-&quot;},{&quot;text&quot;:&quot;1-是&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-否&quot;,&quot;value&quot;:&quot;2&quot;}]" value="" title="—-—"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">—-—</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"> </label><span>
	</span></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">3.醫囑轉社區健康服務機構/鄉鎮衛生院，擬接收機構名稱：</font></font></label><span>
		</span><field tabindex="0" id="AR_FP_RECEPT_HOMEUNIT" name="AR_FP_RECEPT_HOMEUNIT" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="擬接收機構名稱"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">擬接收機構名稱</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">  4.非醫囑轉院 5.死亡 9.其他</font></font></label></p></td>
		</tr><tr style="height: 1.00847cm">
			<td colspan="12" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt; text-align: Justify;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">是否有出院31天內再住院計劃 </font></font></label><span>
		</span><field tabindex="0" id="AR_FP_PLAN_REINP" name="AR_FP_PLAN_REINP" class="" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-无&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-有&quot;,&quot;value&quot;:&quot;2&quot;}]" value="1" title="1-無"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-無</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1.無 2.有 目的：</font></font></label><span>
		</span><field tabindex="0" id="AR_FP_PLAN_REINP_PURPOSE" name="AR_FP_PLAN_REINP_PURPOSE" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="目的"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">目的</font></font></field></p></td>
		</tr><tr style="height: 1.02542cm">
			<td colspan="12" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style="font-family: 宋体; font-size: 10.5pt; text-align: justify; text-indent: 0px;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">顱腦損傷患者昏迷時間：入院前 </font></font></label><span>
		</span><field tabindex="0" id="AR_FP_BEFORE_COMA_D" name="AR_FP_BEFORE_COMA_D" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="天数" title="天數"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">天數</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">天 </font></font></label><span>
		</span><field tabindex="0" id="AR_FP_BEFORE_COMA_H" name="AR_FP_BEFORE_COMA_H" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="小時"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">小時</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">小時</font></font></label><span>
		</span><field tabindex="0" id="AR_FP_BEFORE_COMA_M" name="AR_FP_BEFORE_COMA_M" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="分分鐘"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">分分鐘</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">分鐘 入院後 </font></font></label><span>
		</span><field tabindex="0" id="AR_FP_AFTER_COMA_D" name="AR_FP_AFTER_COMA_D" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="天數"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">天數</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">天 </font></font></label><span>
		</span><field tabindex="0" id="AR_FP_AFTER_COMA_H" name="AR_FP_AFTER_COMA_H" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="小時"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">小時</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">小時 </font></font></label><font style="vertical-align: inherit;"><span><font style="vertical-align: inherit;">分</font></span></font><span>
		</span><span><font style="vertical-align: inherit;"></font></span><field tabindex="0" id="AR_FP_AFTER_COMA_M" name="AR_FP_AFTER_COMA_M" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="分分鐘"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">鐘</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">分分鐘</font></font></label></p></td>
		</tr><tr>
			<td colspan="12" class="" style="border-color: rgb(0, 0, 0)"><span>
	</span><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">入院診斷 </font></font></label><span>
		</span><field tabindex="0" id="RYZD" name="RYZD" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" type="DropdownList" value="" title="入院診斷"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">入院診斷</font></font></field><span>
		</span><field tabindex="0" id="RYZDBM" name="RYZDBM" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="編碼"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">編碼</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 出院情況:</font></font></label><span>
		</span><field tabindex="0" id="CYQK" name="CYQK" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-治愈&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-好转&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-未愈&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;4-死亡&quot;,&quot;value&quot;:&quot;4&quot;},{&quot;text&quot;:&quot;5-自动出院&quot;,&quot;value&quot;:&quot;5&quot;},{&quot;text&quot;:&quot;6-其他&quot;,&quot;value&quot;:&quot;6&quot;}]" value="" title="1-治愈"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-治愈</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1.治癒 2.好轉 3.未癒 4.死亡 5.自動出院 6.其他</font></font></label><span>
	</span></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">診斷符合：門診與出院 </font></font></label><span>
		</span><field tabindex="0" id="MZYCY" name="MZYCY" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;0-未做&quot;,&quot;value&quot;:&quot;0&quot;},{&quot;text&quot;:&quot;1-符合&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-不符合&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-不肯定&quot;,&quot;value&quot;:&quot;3&quot;}]" value="" title="0-未做"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">0-未做</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 入院與出院 </font></font></label><span>
		</span><field tabindex="0" id="RYYCY" name="RYYCY" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;0-未做&quot;,&quot;value&quot;:&quot;0&quot;},{&quot;text&quot;:&quot;1-符合&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-不符合&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-不肯定&quot;,&quot;value&quot;:&quot;3&quot;}]" value="" title="0-未做"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">0-未做</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 術前與術後 </font></font></label><span>
		</span><field tabindex="0" id="SQYSH" name="SQYSH" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;0-未做&quot;,&quot;value&quot;:&quot;0&quot;},{&quot;text&quot;:&quot;1-符合&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-不符合&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-不肯定&quot;,&quot;value&quot;:&quot;3&quot;}]" value="" title="0-未做"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">0-未做</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 臨床與病理 </font></font></label><span>
		</span><field tabindex="0" id="LCYBL" name="LCYBL" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;0-未做&quot;,&quot;value&quot;:&quot;0&quot;},{&quot;text&quot;:&quot;1-符合&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-不符合&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-不肯定&quot;,&quot;value&quot;:&quot;3&quot;}]" value="" title="0-未做"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">0-未做</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 放射線與病理 </font></font></label><span>
		</span><field tabindex="0" id="FSYBL" name="FSYBL" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;0-未做&quot;,&quot;value&quot;:&quot;0&quot;},{&quot;text&quot;:&quot;1-符合&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-不符合&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-不肯定&quot;,&quot;value&quot;:&quot;3&quot;}]" value="" title="0-未做"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">0-未做</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"> </label><label style="font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">0、未做 1、符合 2、不符合 3、不肯定 醫院感染 </font></font></label><span style="font-size: 10.5pt;">
		</span><field tabindex="0" id="YYGR" name="YYGR" class="blank" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-无&quot;,&quot;value&quot;:&quot;2&quot;}]" value="" title="1-有" style="font-size: 10.5pt; text-align: center;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-有</font></font></field><span style="font-size: 10.5pt;">
		</span><label style="font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1、有 2、無 感染名稱</font></font></label><font style="vertical-align: inherit;"><label style="font-size: 10.5pt;"><font style="vertical-align: inherit;">：</font></label></font><span style="font-size: 10.5pt;">
		</span><label style="font-size: 10.5pt;"><font style="vertical-align: inherit;"></font></label><span style="font-size: 10.5pt;">
		</span><field tabindex="0" id="GRMC" name="GRMC" class="blank" type="Text" value="" title="感染名稱" style="font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">感染名稱</font></font></field></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">危重搶救：</font></font></label><span>
		</span><field tabindex="0" id="WZQJ" name="WZQJ" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-无&quot;,&quot;value&quot;:&quot;2&quot;}]" value="" title="1-有"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-有</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1.有 2、無 搶救次數 </font></font></label><span>
		</span><field tabindex="0" id="QJCS" name="QJCS" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" contenteditable="true" type="Text" value="" title="搶救次數"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">搶救次數</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">  成功次數 </font></font></label><span>
		</span><field tabindex="0" id="CGCS" name="CGCS" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" contenteditable="true" type="Text" value="" title="成功次數"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">成功次數</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"> </label><span>
	</span></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">術後非預期重返手術室再手術：</font></font></label><span>
		</span><field tabindex="0" id="ZSS" name="ZSS" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-是&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-否&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;-" -其他","value":"-"}]="" value="" title="1-是"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-是</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1.是 2、否 手術中異物遺留：</font></font></label><span>
		</span><field tabindex="0" id="YWYL" name="YWYL" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-是&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-否&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;-" -其他","value":"-"}]="" value="" title="1-是"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-是</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1、是 2、否</font></font></label><span>
	</span></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">手術中死亡：</font></font></label><span>
		</span><field tabindex="0" id="SSZSW" name="SSZSW" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-是&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-否&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;-" -其他","value":"-"}]="" value="" title="1-是"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-是</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1、是 2、否 手術後死亡 </font></font></label><span>
		</span><field tabindex="0" id="SSHSW" name="SSHSW" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-是&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-否&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;-" -其他","value":"-"}]="" value="" title="1-是"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-是</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">  1.是 2、否 醫源性氣胸 </font></font></label><span>
		</span><field tabindex="0" id="YYXQX" name="YYXQX" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-无&quot;,&quot;value&quot;:&quot;2&quot;}]" value="" title="1-有"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-有</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1、有 2、無</font></font></label><span>
	</span></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">醫源性切、穿刺傷：</font></font></label><span>
		</span><field tabindex="0" id="YYXCS" name="YYXCS" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-无&quot;,&quot;value&quot;:&quot;2&quot;}]" value="" title="1-有"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-有</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1.有 2、無 醫源性撕裂傷：</font></font></label><span>
		</span><field tabindex="0" id="YYXSLS" name="YYXSLS" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-无&quot;,&quot;value&quot;:&quot;2&quot;}]" value="" title="1-有"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-有</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1、有 2、無 </font></font></label><span>
	</span></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">患者因同一疾病再住院：</font></font></label><span>
		</span><field tabindex="0" id="TYJBZZY" name="TYJBZZY" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-15日内再住院&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-31日内再住院&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-无&quot;,&quot;value&quot;:&quot;3&quot;}]" value="" title="1-15日內再住院"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-15日內再住院</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1、15日內再住院 2、31日內再住院 3.無</font></font></label><span>
	</span></p><p style="font-family: 宋体; font-size: 10.5pt; outline: none;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">因用藥錯誤導致患者死亡：</font></font></label><span>
		</span><field tabindex="0" id="YYCWSW" name="YYCWSW" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-是&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-否&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;-" -其他","value":"-"}]="" value="" title="1-是"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-是</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1.是 2、否 由麻醉醫師實施心肺復甦術成功 </font></font></label><span>
		</span><field tabindex="0" id="XFFSCG" name="XFFSCG" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;0-未做&quot;,&quot;value&quot;:&quot;0&quot;},{&quot;text&quot;:&quot;1-是&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-否&quot;,&quot;value&quot;:&quot;2&quot;}]" value="" title="0-未做"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">0-未做</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 0、未做 1、是 2、否</font></font></label><span>
	</span></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">輸液反應：</font></font></label><span>
		</span><field tabindex="0" id="SYFY" name="SYFY" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;0-未输&quot;,&quot;value&quot;:&quot;0&quot;},{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-无&quot;,&quot;value&quot;:&quot;2&quot;}]" value="" title="0-未輸"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">0-未輸</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 0、未輸 1、有 2、無 輸血反應：</font></font></label><span>
		</span><field tabindex="0" id="SXFY" name="SXFY" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;0-未输&quot;,&quot;value&quot;:&quot;0&quot;},{&quot;text&quot;:&quot;1-有&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-无&quot;,&quot;value&quot;:&quot;2&quot;}]" value="" title="0-未輸"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">0-未輸</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 0、未輸 1、有 2、無</font></font></label><span>
	</span></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">輸血品種：1、紅血球</font></font></label><span>
		</span><field tabindex="0" id="HXB" name="HXB" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="紅血球"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">紅血球</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">u 2、血小板</font></font></label><span>
		</span><field tabindex="0" id="XXB" name="XXB" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="血小板"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">血小板</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">治療量 3、血漿</font></font></label><span>
		</span><field tabindex="0" id="XJ" name="XJ" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" contenteditable="true" type="Text" value="" title="血漿"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">血漿</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">ml 4、冷沉澱</font></font></label><span>
		</span><field tabindex="0" id="QX" name="QX" class="blank" style=" font-family: 宋体; font-size: 10.5pt;" contenteditable="true" type="Text" value="" title="冷沉澱"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">冷沉澱</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">u 5、其他</font></font></label><span>
		</span><field tabindex="0" id="QT" name="QT" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" contenteditable="true" type="Text" value="" title="其他"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">其他</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"> </label><span>
	</span></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">抗生素使用情況：</font></font></label><span>
		</span><field tabindex="0" id="KJSSYQK" name="KJSSYQK" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;0-未用&quot;,&quot;value&quot;:&quot;0&quot;},{&quot;text&quot;:&quot;1-预防&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-治疗&quot;,&quot;value&quot;:&quot;2&quot;}]" value="" title="0-未用"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">0-未用</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 0、未用 1、預防 2、治療 細菌培養及藥敏實驗：</font></font></label><span>
		</span><field tabindex="0" id="YMSY" name="YMSY" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-已送检&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-未送检&quot;,&quot;value&quot;:&quot;2&quot;}]" value="" title="1-已送檢"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-已送檢</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1、已送檢 2、未送檢</font></font></label><span>
	</span></p><p style="text-align: center; font-family: 宋体; font-size: 10.5pt;">
		<label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">擇期手術：</font></font></label>&nbsp;<span style="color: rgb(211, 211, 211); background-color: rgb(238, 255, 255);"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">誤</font></font></span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1、是 2、否 擇期手術後併發症：無</font></font></label></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">    1.手術併發症（嚴重但可治療）導致的死亡 2、手術後傷口裂開 3、手術後肺栓塞或深部靜脈血栓</font></font></label><span>
	</span></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">    4.手術後出血或血腫 5、手術後髖關節骨折 6、手術後生理代謝紊亂</font></font></label><span>
	</span></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">    7.手術後呼吸衰竭 8.手術後敗血症</font></font></label><span>
	</span></p><p style=" font-family: 宋体; font-size: 10.5pt;"><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">產傷發生率：</font></font></label><span>
		</span><field tabindex="0" id="CSFSL" name="CSFSL" class="blank" style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;" type="DropdownList" data-list="[{&quot;text&quot;:&quot;1-产伤-新生儿&quot;,&quot;value&quot;:&quot;1&quot;},{&quot;text&quot;:&quot;2-产伤-器械辅助阴道分娩&quot;,&quot;value&quot;:&quot;2&quot;},{&quot;text&quot;:&quot;3-产伤-非器械辅助阴道分娩&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;text&quot;:&quot;-" -空","value":"-"}]="" value="" title="1-產傷-新生兒"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">1-產傷-新生兒</font></font></field><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;"> 1.產傷-新生兒 2、產傷-器械輔助陰道分娩 3、產傷-非器械輔助陰道分娩</font></font></label></p></td>
		</tr></tbody></table></p><p><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">說明：（一）醫療付費方式1.城鎮職工基本醫療保險2.城鎮居民基本醫療保險3.新型農村合作醫療4.貧窮求助5.商業醫療保險6.全公費7.全自費8.其他社區保險9.其他</font></font></label><span>
	</span></p><p style=""><span>
		</span><label style=" font-family: 宋体; font-size: 10.5pt;"><font style="vertical-align: inherit;"><font style="vertical-align: inherit;">      （二）凡是由醫院資訊系統提供住院費用清單的，住院病案首頁中不可以填寫「住院費用」。</font></font></label><span>
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